U.S. Department of Labor

DEC 7 2005

Larry J. Elliott

Director, Office of Compensation Analysis and Support
National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention

Mail Stop C-46

4676 Columbia Parkway

Cincinnati, Ohio 45226

Re: Handling of Mallinckrodt Cases for New SEC Class for 1949 - 1957
Dear Larry:

On October 14, 2005, the Secretary of the Department of Health and Human Services
(HHS), Michael Leavitt, designated the following class for addition to the SEC in a report
to Congress:

Department of Energy (DOE) employees or DOE contractor or
subcontractor employees who worked in the Uranium Division of the
Destrehan Street Facility of Mallinckrodt Chemical Works from 1949 to
1957 and who were employed for a number of work days aggregating at
least 250 work days, either solely under this employment or in
combination with work days within the parameters (excluding aggregate
work day requirements) established for other classes of employees
included in the SEC.

This designation became effective on November 13, 2005, as provided for under 42
U.S.C. 73841(14)(C).

A report attached to Secretary Leavitt's letter, entitled “HHS Designation of Additional
Members of the Special Exposure Cohort,” provided the supporting rationale for
designating a class of employees from the Uranium Division of the Mallinckrodt
Chemical Works, Destrehan Street Facility, St. Louis, Missouri, for the years 1949
through 1957.


Section IV, “Designation Findings,” summarized NIOSH’s finding that“... there is
insufficient information either to estimate the maximum radiation dose for every type of
cancer for which radiation doses are reconstructed that could have been incurred under
plausible circumstances by any member of the class, or to estimate the radiation doses of
members of the class more precisely than a maximum dose estimate with sufficient
accuracy.

The discussion noted, “There is not individual bioassay monitoring or other monitoring
information that can be used to quantify internal exposures to thorium-230, protactinium-
231, and actinium-227 for raffinate workers specifically at the Destrehan Street facility of
Mallinckrodt Chemical Works.”

In addition, “The specific air sample data that exists for the Destrehan Street facility of
Mallinckrodt Chemical Works is insufficient to establish the internal doses from
inhalation of thorium-230, protactinium-231, and actinium-227 at the site with sufficient
accuracy. This is because 1) the air sample data found at the Destrehan Street facility of
Mallinckrodt Chemical Works do not provide radionuclide-specific information for the
site; and 2) very little data are available to characterize the degree of disequilibrium in the
raffinate source term at the Destrehan Street facility of Mallinckrodt Chemical Works.”

The discussion further noted, “Records from the Destrehan Street facility of Mallinckrodt
Chemical Works indicate that during the time frame of 1949 through 1957, employees
may have rotated through a number of different jobs. The changes in work assignments
make it difficult to distinguish the raffinate-exposed workers from the workers who never
worked with raffinate.”

Finally, “It should be noted that the Board believes, and NIOSH concurs, that the
available external dose monitoring information is adequate for the reconstruction of
individual external exposures; where appropriate, individual external doses can be
reconstructed for specific types of cancer (e.g., skin).”

In summary, the Secretary of Health and Human Services has determined that it is not
feasible to undertake dose reconstructions for the class of employees employed at the
Destrehan Street facility of Mallinckrodt Chemical Works from 1949 through 1957.
However, NIOSH has determined that it is possible to reconstruct individual occupational
external doses for certain cancers.

Thus, NIOSH should provide two lists of employees at the Destrehan Street facility of
Mallinckrodt Chemical Works for the SEC class period. One list should cover employees
with specified cancers and the other list should address employees with non-specified
cancers, NIOSH should return all cases with specified cancers (with the administrative
record on a CD) to the Department of Labor Denver District Office for the Office of
Workers’ Compensation Programs to complete adjudication as appropriate. Since
NIOSH has determined that it is possible to estimate external exposure, it will continue to
perform dose reconstructions for cases with non-specified cancers for the SEC class time
period based solely on external occupational dose. DOL will review employment and


medical information for both lists of employees. If the district office identifies a case
with a specified cancer during its review of cases with non-specific cancers, DOL will
request the return of that case from NIOSH on an individual basis.

Sincerely,
—S =
\ ° 7 ‘ | greece

Peter M. Turcic
Director, Division of Energy Employees
Occupational IIIness Compensation